Prognostic significance of glycemic variability after cardiac surgery

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• 作者：Beena Bansal^a ; ^{beenabansal1975@yahoo.co.in" class="auth_mail" title="E-mail the corresponding author} ; Pravin Carvalho^b ; ¹ ; ^{pravincar@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Yatin Mehta^c ; ² ; ^{yatin.mehta@medanta.org" class="auth_mail" title="E-mail the corresponding author} ; Jitender Yadav^a ; ³ ; ^{jitenderyadav82@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Prateek Sharma^d ; ⁴ ; ^{drprateek2412@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Ambrish Mithal^a ; ⁵ ; ^{ambrish.mithal@medanta.org" class="auth_mail" title="E-mail the corresponding author} ; Naresh Trehan^e ; ⁶ ; ^{naresh.trehan@medanta.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Glycemic variability ; Standard deviation ; Cardiac surgery
• 刊名：Journal of Diabetes and its Complications
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：30
• 期：4
• 页码：613-617
• 全文大小：245 K

文摘

The prognostic significance of acute glycemic variability (GV) after cardiac surgery is not known. This study was therefore planned to analyze the independent prognostic value of GV after cardiac surgery.

<h4 id="absSec_2">Materials and methodsh4>

This is a single center prospective observational study in 870 consecutive cardiac surgery patients over a 3-month period at a tertiary care institute in India.

<h4 id="absSec_3">Resultsh4>

In linear regression analysis, GV was a significant predictor of length of stay in intensive care unit (LOS-ICU) (beta 0.102, p = 0.007) and rise in creatinine after surgery (beta 0.229, p < 0.001). Mean POC-BG was a significant positive predictor of length of stay in hospital (LOS-hospital) (beta 0.1, p = 0.004). In multivariable logistic regression analysis, GV predicted prolonged LOS-ICU (p = 0.006, OR 1.016) and acute kidney injury (p < 0.001, OR 1.034).

<h4 id="absSec_4">Conclusionh4>

This study showed that GV, as measured by standard deviation, was a predictor of LOS-ICU, rise in creatinine and AKI after cardiac surgery. GV is therefore a new dimension in postoperative glycemic management in cardiac surgery patients, which needs to be explored.